How To Background Your Doctor Like An Investigative Reporter
You put your health in the hands of your clinicians. Use public sources to identify possible red flags and inform your conversations and decisions.
I loved my chiropractor, so when my wife had ongoing back and neck pain, I booked an appointment for her with him.
We attended the appointment together, but when we showed up to his office, we got an unexpected surprise. We were told that my chiropractor had retired, and that we would be seen by a chiropractor who had replaced him.
Hmmmm…that seemed odd. They should have told me he had retired when I made the appointment. All chiropractors – or doctors or other clinicians – are not created equal.
Plus, I do background checks on my doctors.
My wife worked on the new patient paperwork while I used my phone to look up the name of the new chiropractor on the website of the New Jersey Department of Consumer Affairs. Every doctor or chiropractor is required to be licensed by a medical board or similar entity, depending on their state and specialty. It’s easy to check their online profile to see if there are any red flags, such as disciplinary action or malpractice cases.
Often the disciplinary records are right there online – as they were for this particular chiropractor.
“Respondent pleaded guilty to and was convicted of possession of a controlled dangerous substance (heroin) with intent to distribute,” the disciplinary document said.
The document went on to say that the chiropractor had been sentenced to five years of drug court, lost his driver’s license for six months and had his chiropractic license suspended for two years.
I showed my wife the disciplinary record and we agreed she didn’t need to bother completing the paperwork. Things were about to get a little awkward, so she went to the car.
I asked for the chiropractor, and when he came to the lobby I asked if he was the same guy who had pleaded guilty to heroin possession.
“My attorney said that was going to be removed from my record,” he told me.
“That’s not how it works,” I replied.
We chose to go elsewhere.
This particular chiropractor might have an inspiring second chance story. Perhaps he’s a guy who has served his time and redeemed himself. But I didn’t like the switcheroo when I made the appointment, and I certainly didn’t like his answer when I asked him about his criminal history and disciplinary record.
I have done extensive reporting on the quality of medical care in the United States. I co-created the ProPublica Surgeon Scorecard, which was the first site to publicly report complications for individual surgeons. (It hasn’t been updated, unfortunately, so it’s now a historical snapshot.) I’ve investigated the cases of hundreds of patients who have been harmed while undergoing medical care and moderated a Facebook group every day for six years for people who were victims of adverse medical events. I’ve seen the best and the worst when it comes to the quality of health care.
In this column, I show how you can background your doctor like an investigative reporter. The techniques apply for doctors, chiropractors, nurses and other licensed medical professionals.
Let’s start with some unfortunate limitations. The quality of health care is barely measured in the United States. There is no publicly reported data that shows the quality of doctors or other clinicians. That’s a huge embarrassment to the system and points to a lack of accountability.
The information you can find may be limited, but it’s still valuable. You can use it to inform your decisions and guide your conversations. Sometimes it’s a game changer.
I’ll focus on six sources to check: licensing boards, board certification, Medicare utilization, medical malpractice cases, academic research and patient reviews. In a future column I’ll share some key questions to ask doctors when you meet with them.
Here are the steps I take to background any doctor or medical professional:
Look up their licensing board profile
Medical professionals are required to be licensed in their state. Their licensing boards post profiles where you can find basic demographic information about the doctor: where they went to medical school and residency and when they graduated, board certification, medical malpractice cases and more. The board also posts any disciplinary actions it may have taken against the doctor.
Most medical professionals have never been disciplined, so it’s a red flag if they have had any discipline, even something minor. I recently helped my friend research his urologist and found that while the doctor had not been disciplined by the Texas medical board, he had self-reported a DWI criminal offense from 2004. That’s something I might ask the doctor about, but it wouldn’t necessarily be a dealbreaker.
The urologist’s profile also showed that he was born in 1967, which puts him at about 55-years-old. That’s in the sweet spot range in my opinion – old enough to be experienced, but not too old. If a doctor is quite young, I will inquire about their experience. If they are quite old, I’ll ask whether they’ve been keeping their skills up to date.
Check their board certification
Doctors go through specialty training and pass examinations to become board certified specialists. You can verify the board certification for urologists, for example, at the website of the The American Board of Urology. Other specialties also allow you to verify a doctor’s board certification on their sites.
Look up the procedures they’ve performed on Medicare patients
The Medicare Physician & Other Practitioner Look-up Tool won’t tell you the quality of care provided by a doctor. But it will let you peek at Medicare data to see what type of services a doctor has performed, and how often. This is important because volume is a big indicator of quality for doctors. You want to know how often they’ve performed the type of procedure or test they’re going to perform on you. Remember, this data is limited to just fee-for-service Medicare patients. It doesn’t capture a doctor’s entire caseload.
See if they’ve been sued for medical malpractice
Medical board physician profiles often list medical malpractice cases, but the information may be self-reported, and some states don’t require it. The most reliable sources for medical malpractice information are the courthouses where cases are filed. Medical malpractice cases are often filed in the county court where the doctor practices, and typically there’s a case search tool on the court’s website.
You may need to check more than one county court site if the doctor practices in multiple locations. And you may need to try some varying searches to be sure you don’t miss any cases. For example, try putting “M.D” after a doctor’s last name in case that’s how they listed the physician as a defendant. If you need to see documents related to the case, those might be available on the court website, or you can go to the courthouse and view them all for free. For federal lawsuits, search the PACER system.
Look to see if they’ve done academic research
If you’re going to a doctor for something specialized, it’s a good sign if the physician has conducted research in the area that interests you. Search for the doctor in Google Scholar and see what they have published. Many doctors do not publish or stop doing research when they completed their training. So it’s not necessarily a problem if they aren’t publishing studies. But it’s commendable if they have continued to do research in their area of expertise, and it might be relevant for you as a patient.
Check their online reviews
Yelp and Google are among the places to look for reviews. I take online reviews with a grain of salt, but I don’t dismiss them. If the reviews show a pattern of complaints, that’s concerning. Or if a review accuses a clinician of being particularly inattentive or uncaring it’s something I might note.
It’s important to get the physician’s side of the story about negative reviews. There might be good explanations that would put bad reviews into context and alleviate any concerns. I would ask the doctor about any concerning reviews in an appointment, to hear his answer and to see how he responds when I bring up something that could be uncomfortable. If I’m putting my life in the hands and judgement of a physician, I want him to be able to discuss sensitive topics with candor.
OK, so those are the sources. What are you supposed to make of the information you find? It depends on what comes up! Sometimes it’s clear – like it was for me with the chiropractor with the criminal record. Other times you learn tidbits of information that help you piece together a general assessment of the clinician. Often, you learn information that you can bring up when you meet with the doctor.
Most clinicians are competent and get into health care for the right reasons. But some are careless or incompetent – or worse – and that can put patients in danger. Good doctors are proud of their work and have no problem talking to patients about the quality of care they provide. Let’s not shy away from investigating their work and inquiring.
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It’s fun for me to see readers continue to point to my book as a helpful resource. “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win,” makes a lovely Christmas present. Hint. Hint. Check it out and get a copy for your loved ones!
Want to get the same great health literacy content without having to read the book? Check out my Never Pay Pathway health literacy videos, which are based on the book.
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Where can I learn if my primary care practice is owned by a private equity company?
This is super helpful but I already encountered a problem. I have a new urologist, and I actually like her. She pays attention, listens to questions, answers them, returns messages. The website of her medical group says she is board certified. I cannot find her on the American Board of Urology website. So I am confused. I will continue to use the resources you gave because I don't trust most doctors when all they do is to prescribe medication. I had one specialist saying to my face that he didn't want to talk about ways to add to treatments, like diets and exercises to help with the issues.